- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15.68 / $25.22 / $61.25
| Facility | | $15.68 | $25.22 | $61.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.28 / $17.88 / $18.43
| Professional | | $15.28 | $17.88 | $18.43 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.40 / $12.40 / $12.40
| Professional | | $12.40 | $12.40 | $12.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.00 / $22.19 / $53.16
| Facility | | $14.00 | $22.19 | $53.16 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $13.83 / $23.60 / $31.49
| Professional | | $13.83 | $23.60 | $31.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16.75 / $93.26 / $150.32
| Facility | | $16.75 | $93.26 | $150.32 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.40 / $12.40 / $24.49
| Professional | | $12.40 | $12.40 | $24.49 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2.48 / $9.92 / $13.64
| Professional | | $2.48 | $9.92 | $13.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20.67 / $20.67 / $31.00
| Facility | | $20.67 | $20.67 | $31.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $8.03 / $10.02 / $28.89
| Professional | | $8.03 | $10.02 | $28.89 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.71 / $12.40 / $12.40
| Professional | | $10.71 | $12.40 | $12.40 |